Influence of the time-task constraint on ocular metrics of semi-elite soccer players

This study novelty aimed to investigate the influence of manipulating the available time to perform the training tasks on soccer players´ ocular metrics, following training. Specifically, pupillary response (pupil diameter) and saccadic features (latency, accuracy, velocity, and number) were measured with a portable eye tracker following training to reflect the mental load accumulated by players during the training sessions. Nine semi-elite soccer players performed two training sessions, based on large-sided games, on an artificial grass field. These two sessions were composed of the same tasks but varying the required time to complete the task goals (Session 1: No time limitations to perform the tasks; Session 2: Limited time to perform the tasks). The participants performed, before (pre-test) and after (post-test) each training session, a prosaccade task in a room near the playing field. Findings revealed a differentiated effect of the available time to complete the training tasks on ocular metrics because significant differences were found in all variables after training (p < .001 for pupil diameter; p < .01 for saccade accuracy and number of saccades; p < .05 for saccade velocity and latency). Ocular metrics could be a promising tool to evaluate mental load following practice because they were sensitive to the time-task constraint, providing researchers a valuable information for a better planning of the mental workload when designed training tasks.

Effects of colour-coded compartmentalised syringe trays on anaesthetic drug error detection under cognitive load

BACKGROUND

Anaesthetic drug administration is complex, and typical clinical environments can entail significant cognitive load. Colour-coded anaesthetic drug trays have shown promising results for error identification and reducing cognitive load.

METHODS

We used experimental psychology methods to test the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a simulated visual search task. Effects of cognitive load were also explored through an accompanying working memory-based task. We hypothesised that colour-coded compartmentalised trays would improve drug-detection error, reduce search time, and reduce cognitive load. This comprised a cognitive load memory task presented alongside a visual search task to detect drug errors.

RESULTS

All 53 participants completed 36 trials, which were counterbalanced across the two tray types and 18 different vignettes. There were 16 error-present and 20 error-absent trials, with 18 trials presented for each preloaded tray type. Syringe errors were detected more often in the colour-coded trays than in the conventional trays (91% vs 83%, respectively; P=0.006). In signal detection analysis, colour-coded trays resulted in more sensitivity to the error signal (2.28 vs 1.50, respectively; P<0.001). Confidence in response accuracy correlated more strongly with task performance for the colour-coded tray condition, indicating improved metacognitive sensitivity to task performance (r=0.696 vs r=0.447).

CONCLUSIONS

Colour coding and compartmentalisation enhanced visual search efficacy of drug trays. This is further evidence that introducing standardised colour-coded trays into operating theatres and procedural suites would add an additional layer of safety for anaesthetic procedures.

Impact of Electronic Health Record Use on Cognitive Load and Burnout Among Clinicians: Narrative Review

The cognitive load theory suggests that completing a task relies on the interplay between sensory input, working memory, and long-term memory. Cognitive overload occurs when the working memory's limited capacity is exceeded due to excessive information processing. In health care, clinicians face increasing cognitive load as the complexity of patient care has risen, leading to potential burnout. Electronic health records (EHRs) have become a common feature in modern health care, offering improved access to data and the ability to provide better patient care. They have been added to the electronic ecosystem alongside emails and other resources, such as guidelines and literature searches. Concerns have arisen in recent years that despite many benefits, the use of EHRs may lead to cognitive overload, which can impact the performance and well-being of clinicians. We aimed to review the impact of EHR use on cognitive load and how it correlates with physician burnout. Additionally, we wanted to identify potential strategies recommended in the literature that could be implemented to decrease the cognitive burden associated with the use of EHRs, with the goal of reducing clinician burnout. Using a comprehensive literature review on the topic, we have explored the link between EHR use, cognitive load, and burnout among health care professionals. We have also noted key factors that can help reduce EHR-related cognitive load, which may help reduce clinician burnout. The research findings suggest that inadequate efforts to present large amounts of clinical data to users in a manner that allows the user to control the cognitive burden in the EHR and the complexity of the user interfaces, thus adding more "work" to tasks, can lead to cognitive overload and burnout; this calls for strategies to mitigate these effects. Several factors, such as the presentation of information in the EHR, the specialty, the health care setting, and the time spent completing documentation and navigating systems, can contribute to this excess cognitive load and result in burnout. Potential strategies to mitigate this might include improving user interfaces, streamlining information, and reducing documentation burden requirements for clinicians. New technologies may facilitate these strategies. The review highlights the importance of addressing cognitive overload as one of the unintended consequences of EHR adoption and potential strategies for mitigation, identifying gaps in the current literature that require further exploration.

What motivates information (non-)seeking behaviors about a healthy diet?

Previous research on health information seeking has primarily focused on individuals'intentions to seek or avoid information. However, limited empirical evidence exists regarding the actual behavioral patterns of information-seeking and non-seeking. To address this, we conducted a survey experiment manipulating cognitive load with mostly Belgian participants (N = 359). By integrating self-report and behavioral data, we investigated motivations and conditions associated with information (non)-seeking behaviors on a healthy diet. Guided by the risk information seeking and processing (RISP) model, we examined the roles of informational subjective norms and information insufficiency, as well as the moderating role of cognitive capacity. Neither informational subjective norms nor information insufficiency significantly correlated with information-seeking behaviors. However, a significant interaction between the predictors and cognitive capacity in predicting non-seeking behaviors was observed. These findings underscore the intricate nature of individuals' behavioral patterns in seeking or not seeking information about healthy eating.

The Dynamics of Resting-State EEG and Salivary Trace Elements in Patients with Obsessive-Compulsive Disorder

The study of salivary microelements and their neurophysiological and behavioral correlates in patients with obsessive-compulsive disorder (OCD) is a pressing issue in modern psychiatry, which, however, lacks adequate research at this time. In this study, we tested the dynamics of behavioral parameters, resting-state electroencephalogram (EEG), and salivary iron, copper, manganese, magnesium, and zinc in 30 healthy volunteers and 30 individuals with OCD before and after an emotional antisaccade task. The eye-movement data served as a measure of behavioral performance. Our research revealed consistently higher manganese concentrations in the OCD group compared to healthy volunteers associated with a higher EEG ratio of amplitude transformation and symptom severity. The dynamics of salivary microelements and resting-state EEG, possibly influenced by cognitive and emotional load during the anticsaccade task, differed between groups. In healthy volunteers, there was a decrease in salivary iron level with an increase in high-frequency power spectral density of EEG. The OCD group showed a decrease in salivary copper with an increased Hjorth mobility of EEG.

Windows into spatial cognition: Mechanisms by which gesture-based instruction improve anatomy learning

The ability to create efficient "mental models" or representations of anatomical structures is crucial for achieving competence in most areas of anatomy. Gesture-based teaching has been recognized to lighten cognitive loads and allow superior mental model creation compared to non-gestural teaching practices. This commentary explores the cognitive basis and possible mechanisms behind this advantage such as (1) reducing visual working memory load, (2) allowing parallel and sequential development of internal representations, and (3) facilitating preferential feature extraction and improved organization of spatial information. We also highlight how information transfer limitations of the gestural medium, interestingly, unveil features and organizational motifs preserved in the "expert's" mental schemas concerning particular anatomical structures. The universal and innate use of gestures in communication, their visual nature, and the ability to break down complex spatial information through sequential steps, all add to the immense potential of this subtle yet powerful tool of hand gestures. As pedagogical practices in the anatomical sciences continue to evolve largely towards technology-enhanced teaching utilizing perceptually richer media, the unique advantages of gesture-based teaching need to be reemphasized.

Dopaminergic versus anticholinergic treatment effects on physiologic complexity of hand tremor in Parkinson's disease: A randomized crossover study

AIMS

Parkinsonian tremor (PT) is regulated by numerous neurophysiological components across multiple temporospatial scales. The dynamics of tremor fluctuation are thus highly complex. This study aimed to explore the effects of different medications on tremor complexity, and how the underlying factors contribute to such tremor complexity.

METHODS

In this study, 66 participants received a 2-mg dose of benzhexol or a pre-determined dose of levodopa at two study visits in a randomized order. Before and after taking the medications, tremor fluctuation was recorded using surface electromyography electrodes and accelerometers in resting, posture, and weighting conditions with and without a concurrent cognitive task. Tremor complexity was quantified using multiscale entropy.

RESULTS

Tremor complexity in resting (p = 0.002) and postural condition (p < 0.0001) was lower when participants were performing a cognitive task compared to a task-free condition. After taking levodopa and benzhexol, participants had increased (p = 0.02-0.03) and decreased (p = 0.03) tremor complexity compared to pre-medication state, respectively. Tremor complexity and its changes as induced by medications were significantly correlated with clinical ratings and their changes (β = -0.23 to -0.39; p = 0.002-0.04), respectively.

CONCLUSION

Tremor complexity may be a promising marker to capture the pathophysiology underlying the development of PT, aiding the characterization of the effects medications have on PT regulation.

Association of brain-autonomic activities and task accuracy under cognitive load: a pilot study using electroencephalogram, autonomic activity measurements, and arousal level estimated by machine learning

The total amount of mental activity applied to working memory at a given point in time is called cognitive load, which is an important factor in various activities in daily life. We have proposed new feature quantities that reflect the time-series changes in the power of typical frequency bands in electroencephalogram (EEG) for use in examining the relationship between brain activity and behavior under cognitive load. We also measured heart rate variability (HRV) and spontaneous skin conductance responses (SCR) to examine functional associations among brain activity, autonomic activity, and behavior under cognitive load. Additionally, we applied our machine learning model previously developed using EEG to the estimation of arousal level to interpret the brain-autonomic-behavior functional association under cognitive load. Experimental data from 12 healthy undergraduate students showed that participants with higher levels of infra-slow fluctuations of alpha power have more cognitive resources and thus can process information under cognitive load more efficiently. In addition, HRV reflecting parasympathetic activity correlated with task accuracy. The arousal level estimated using our machine learning model showed its robust relationship with EEG. Despite the limitation of the sample size, the results of this pilot study suggest that the information processing efficiency of the brain under cognitive load is reflected by time-series fluctuations in EEG, which are associated with an individual's task performance. These findings can contribute to the evaluation of the internal state of humans associated with cognitive load and the prediction of human behaviors in various situations under cognitive load.

Cognitive mental workload of emergency nursing: A scoping review

AIM

Emergency nurses work in an environment of high cognitive mental workload. Excessive cognitive mental workload may result in patient harm and nurses' burnout. Therefore, it is necessary to understand nurses' subjective experience of cognitive workload. This scoping review aimed to curate literature about the subjective experience of cognitive mental workload reported by nurses and psychometric measures of the phenomenon.

DESIGN

The scoping review was conducted in accordance with JBI methodology and reported using PRISMA extension for scoping review checklist.

METHODS

A priori protocol was created with Peer Review of Electronic Search Strategies checklist and registered in the OSF registry. Databases including PubMed, CINAHL, ProQuest, Scopus, Science Direct, Web of Science and Google Scholar were searched. Published reports were reviewed against the eligibility criteria by performing Title and Abstract screening, followed by Full-text screening. The initial search yielded 1373 studies. Of these, 57 studies met the criteria for inclusion in this study.

RESULTS

The search revealed five general measures of cognitive mental workload and their variations. Only one customised measure specifically for medical-surgical nurses was found in the study. Identified measures were collated and categorised into a framework for conceptual clarity. NASA Task Load Index and its variations were the most popular subjective measure of cognitive mental workload in nursing. However, no measure or self-report scale customised for emergency nurses was identified.

PATIENT OR PUBLIC CONTRIBUTION

The findings of this scoping review can inform future research into the cognitive mental workload of nurses. The findings have implications for workplace health and safety for nurses and patients.

Physiologic measurements of cognitive load in clinical reasoning

OBJECTIVES

Cognitive load is postulated to be a significant factor in clinical reasoning performance. Monitoring physiologic measures, such as Heart Rate Variability (HRV) may serve as a way to monitor changes in cognitive load. The pathophysiology of why HRV has a relationship to cognitive load is unclear, but it may be related to blood pressure changes that occur in a response to mental stress.

METHODS

Fourteen residents and ten attendings from Internal Medicine wore Holter monitors and watched a video depicting a medical encounter before completing a post encounter form used to evaluate their clinical reasoning and standard psychometric measures of cognitive load. Blood pressure was obtained before and after the encounter. Correlation analysis was used to investigate the relationship between HRV, blood pressure, self-reported cognitive load measures, clinical reasoning performance scores, and experience level.

RESULTS

Strong positive correlations were found between increasing HRV and increasing mean arterial pressure (MAP) (p=0.01, Cohen's d=1.41). There was a strong positive correlation with increasing MAP and increasing cognitive load (Pearson correlation 0.763; 95 % CI [; 95 % CI [-0.364, 0.983]). Clinical reasoning performance was negatively correlated with increasing MAP (Pearson correlation -0.446; 95 % CI [-0.720, -0.052]). Subjects with increased HRV, MAP and cognitive load were more likely to be a resident (Pearson correlation -0.845; 95 % CI [-0.990, 0.147]).

CONCLUSIONS

Evaluating HRV and MAP can help us to understand cognitive load and its implications on trainee and physician clinical reasoning performance, with the intent to utilize this information to improve patient care.

Relationship Between Cognitive Load Theory, Intrinsic Motivation and Emotions in Healthcare Professions Education: A Perspective on the Missing Link

Cognitive Load Theory (CLT) is one of the key cognitive theories that have been used to assess learners' information and working memory load. CLT has been applied to Simulation Based Education (SBE) and optimizing instructional design. However, a challenge that occurs is that these high-fidelity simulations and mannequins of critically ill patients can elicit negative emotions in learners which can unfavorably impact the learning process. There is also a potential for cognitive overload if the simulation is more authentic and requires more dynamic interactions and lead to high levels of anxiety due to a novel learning environment, which can also have detrimental effects on learning process. Hence, it is critical for health professional educators (HPE) to know how to minimize cognitive load to improve learning as a professional in a workplace setting. The literature on the role of emotions, intrinsic motivation, cognitive load is scarce in HPE literature. Specifically when not being studied together at once since they move dynamically together and affect the learning for the learner. Therefore, the purpose of this perspective paper is to cover the gap in the literature and propose a framework and recommendation for future HPE research.

The Aerial Guide Dog: A Low-Cognitive-Load Indoor Electronic Travel Aid for Visually Impaired Individuals

Most navigation aids for visually impaired individuals require users to pay close attention and actively understand the instructions or feedback of guidance, which impose considerable cognitive loads in long-term usage. To tackle the issue, this study proposes a cognitive burden-free electronic travel aid for individuals with visual impairments. Utilizing human instinctive compliance in response to external force, we introduce the "Aerial Guide Dog", a helium balloon aerostat drone designed for indoor guidance, which leverages gentle tugs in real time for directional guidance, ensuring a seamless and intuitive guiding experience. The introduced Aerial Guide Dog has been evaluated in terms of directional guidance and path following in the pilot study, focusing on assessing its accuracy in orientation and the overall performance in navigation. Preliminary results show that the Aerial Guide Dog, utilizing Ultra-Wideband (UWB) spatial positioning and Measurement Unit (IMU) angle sensors, consistently maintained minimal deviation from the targeting direction and designated path, while imposing negligible cognitive burdens on users while completing the guidance tasks.

An Individualized Approach to Skin Conductance Assessment during Execution of Tasks of Different Complexities

Researchers use different approaches to analyze changes in skin conductance. At the same time, individual differences observed in both the initial values of skin conductance and response to stimuli do not allow comparing the responses of different subjects to the same impact. An individualized approach to the assessment of psycho-emotional stress has been developed using the real-time skin conductance index during continuous performance of a task with different levels of complexity. The participants, 18 second-year students at the actors' high school, performed a simple task (expressive reading aloud of a simple text) and a difficult task (expressive reading aloud of the text inverted 180°). During the task, the skin conductance in the participants was continuously recorded. We revealed a change in the parameters of skin conductivity depending on the complexity of the task, both in comparison with resting state (baseline) and with simple and complex stages of the study. However, the individual skin conduction curves in the subjects differed greatly. A method for assessing the individual differences in parameters of skin conductance was proposed based on ranking by categories of values during continuous performance of tasks with different levels of complexity. This method allows comparing the levels of cognitive load in participants with different initial levels of skin conductance due to transition from the absolute to relative values at time intervals that are important for the researcher.

Craving modulates attentional bias towards alcohol in severe alcohol use disorder: An eye-tracking study

BACKGROUND AND AIMS

Competing models disagree on three theoretical questions regarding alcohol-related attentional bias (AB), a key process in severe alcohol use disorder (SAUD): (1) is AB more of a trait (fixed, associated with alcohol use severity) or state (fluid, associated with momentary craving states) characteristic of SAUD; (2) does AB purely reflect the over-activation of the reflexive/reward system or is it also influenced by the activity of the reflective/control system and (3) does AB rely upon early or later processing stages? We addressed these issues by investigating the time-course of AB and its modulation by subjective craving and cognitive load in SAUD.

DESIGN

A free-viewing eye-tracking task, presenting pictures of alcoholic and non-alcoholic beverages, combined with a concurrent cognitive task with three difficulty levels.

SETTING

A laboratory setting in the detoxification units of three Belgian hospitals.

PARTICIPANTS

We included 30 patients with SAUD self-reporting craving at testing time, 30 patients with SAUD reporting a total absence of craving and 30 controls matched on sex and age. All participants from SAUD groups met the DSM-5 criteria for SAUD.

MEASUREMENTS

We assessed AB through early and late eye-tracking indices. We evaluated the modulation of AB by craving (comparison between patients with/without craving) and cognitive load (variation of AB with the difficulty level of the concurrent task).

FINDINGS

Dwell time measure indicated that SAUD patients with craving allocated more attention towards alcohol-related stimuli than patients without craving (P < 0.001, d = 1.093), resulting in opposite approach/avoidance AB according to craving presence/absence. SAUD patients without craving showed a stronger avoidance AB than controls (P = 0.003, d = 0.806). AB did not vary according to cognitive load (P = 0.962, η2 p  = 0.004).

CONCLUSIONS

The direction of alcohol-related attentional bias (approach/avoidance) appears to be determined by patients' subjective craving at testing time and does not function as a stable trait of severe alcohol use disorder. Alcohol-related attentional bias appears to rely on later/controlled attentional stages but is not modulated by the saturation of the reflective/control system.

The Right-Ear Advantage in Static and Dynamic Cocktail-Party Situations

When presenting two competing speech stimuli, one to each ear, a right-ear advantage (REA) can often be observed, reflected in better speech recognition compared to the left ear. Considering the left-hemispheric dominance for language, the REA has been explained by superior contralateral pathways (structural models) and language-induced shifts of attention to the right (attentional models). There is some evidence that the REA becomes more pronounced, as cognitive load increases. Hence, it is interesting to investigate the REA in static (constant target talker) and dynamic (target changing pseudo-randomly) cocktail-party situations, as the latter is associated with a higher cognitive load than the former. Furthermore, previous research suggests an increasing REA, when listening becomes more perceptually challenging. The present study examined the REA by using virtual acoustics to simulate static and dynamic cocktail-party situations, with three spatially separated talkers uttering concurrent matrix sentences. Sentences were presented at low sound pressure levels or processed with a noise vocoder to increase perceptual load. Sixteen young normal-hearing adults participated in the study. The REA was assessed by means of word recognition scores and a detailed error analysis. Word recognition revealed a greater REA for the dynamic than for the static situations, compatible with the view that an increase in cognitive load results in a heightened REA. Also, the REA depended on the type of perceptual load, as indicated by a higher REA associated with vocoded compared to low-level stimuli. The results of the error analysis support both structural and attentional models of the REA.

Global practitioner assessment and management of mental fatigue and mental recovery in high-performance sport: A need for evidence-based best-practice guidelines

BACKGROUND

Mental fatigue and mental recovery have gained scientific attention in relation to sporting performance, yet best practice assessment and management methods are lacking. A greater understanding of current knowledge and practices in high-performance sport are necessary.

OBJECTIVE

To understand the contemporary knowledge, beliefs, monitoring processes, management strategies, perceived responsibility, sources of evidence, and challenges, when assessing the mental fatigue and mental recovery of athletes in high-performance sport.

METHODS

A mixed-methods survey approach obtained information from 156 multi-disciplinary high-performance sport practitioners. Descriptive outputs were reported and potential differences between key concepts were detected using Wilcoxon-signed rank analysis. Thematic analysis interpreted open-text responses.

RESULTS

Only 11.5% and 5.1% of respondents indicated they were "very" knowledgeable about mental fatigue and mental recovery, respectively. Knowledge (p < 0.001) and confidence in application (p = 0.001) were significantly greater for mental fatigue than mental recovery. Nearly all respondents perceived mental fatigue and mental recovery impacted training and competition performance, with a greater negative impact during competition (p < 0.001). A limited number of respondents reported deliberate assessment (31.1%) or management (51.2%) of mental fatigue and mental recovery. A combination of sources of evidence were used to inform practice, with common challenges to implementation including staff knowledge, athlete-buy in, time-availability, and a lack of evidence. Practitioners reported that assessing and managing mental fatigue and mental recovery was multi-disciplinary in nature.

CONCLUSION

Practitioners reported that mental fatigue and mental recovery did impact performance, yet this was not reflected in the implementation of evidence-based assessment and management practices in high-performance sport.

Dark mode vogue: Do light-on-dark displays have measurable benefits to users?

This work investigates the effect of display polarity on cognitive load, using eye-tracking and subjective measures, and emotional reactions to assess whether the popularity of negative polarity displays is related to affective qualities or true physiological benefits. Younger and older adults tested positive and negative polarities under bright and dim environments for writing and search tasks. Eye-tracking results showed higher cognitive load using negative polarity, reflected in increased search time and pupil diameter for older adults in a bright environment and younger adults in a dim environment. For older adults, mental effort scores were higher using negative polarity for the search task in a bright environment. This group reported more positive emotions using positive polarity, while younger adults expressed more interest in negative polarity. These results suggest that older adults use positive polarity to avoid mental fatigue, while younger adults use negative polarity in a dim environment for aesthetic reasons. Practitioner summary: The effects of negative polarity on cognitive load and users' preferences are often unclear. Eye-tracking and subjective data reveals that negative polarity displays elicit higher cognitive load for older adults in a bright environment and younger adults in a dim environment, suggesting older adults prioritise reduced fatigue while younger adults prioritise the feel of the interface.

Energetic and Cognitive Demands of Treading Water: Effects of Technique and Expertise

Being able to tread water effectively can improve the likelihood of survival following accidental immersion. People tread water in various ways, ranging from rudimentary 'doggy-paddle' to more elaborate techniques like the eggbeater, but little is known about the energetic and cognitive requirements of treading water. We therefore aimed to measure the demands of treading water techniques for people of different experience levels. Three cohorts, comprising 21 adult water treading experts (water polo players), 15 intermediate swimmers and 16 inexperienced swimmers, treaded water for 3 min each using four different techniques while cognitive and energetic economy measures were taken. For inexperienced swimmers, the flutter kick and breaststroke patterns produced the lowest self-reported physical and task load (rating of perceived exertion, NASA task load index), while cognitive (probe reaction time), cardiac (heart rate) and metabolic (oxygen consumption) load did not differ between techniques. In contrast, for expert water treaders, both breaststroke and eggbeater patterns produced lower cognitive, cardiac and metabolic loads. For intermediate swimmers, breaststroke resulted in the lowest cardiac and metabolic loads, as well as self-reported task load. Probe reaction time was highest while performing the eggbeater technique, indicating that this technique was challenging to coordinate and cognitively demanding. While the energetic demands of antiphase kicking patterns (such as eggbeater in experts or flutter kick in beginners) may be similarly low, the symmetric coordination of upright breaststroke may explain why this pattern's cognitive economy was favourable for all groups. As the eggbeater can be challenging to perform for many people, an upright breaststroke technique is an adequate alternative to adopt in survival situations.

Positive emotion up-regulation is resistant to working memory load: An electrocortical investigation of reappraisal and savoring

Studies of emotion regulation to-date have mostly focused on negative emotion down-regulation, leaving positive emotion up-regulation poorly understood, particularly regarding factors that may modulate its success. While reappraisal and savoring have been shown to be effective at increasing electrocortical and subjective response to pictures in controlled laboratory settings, it remains unclear whether individuals can effectively enact these techniques to willfully increase positive emotions in everyday life when faced with other concurrent distractions/demands. Here, we used the late positive potential (LPP), an electrocortical measure that is larger for emotional compared to neutral stimuli, to assess the effect of working memory (WM) load on individuals' ability to reappraise or savor positive pictures. Seventy-six participants were randomly assigned to use either reappraisal or savoring to up-regulate positive emotion to pictures. Following training, participants engaged in a positive emotion up-regulation task interspersed with high and low WM load trials, while EEG was recorded. Frequentist and Bayesian statistics showed that although high WM load seemed to consume resources and reduced picture processing overall, it did not interfere with the enhancement of the LPP via positive emotion up-regulation. Nonetheless, WM performance (especially on high-load trials) was worse when participants were engaged in positive emotion up-regulation. Therefore, while both techniques appear to be effective under concurrent WM load, positive emotion up-regulation may interfere with other ongoing tasks.

The interactive effects of different facets of threat uncertainty and cognitive load in shaping fear and anxiety responses

A large body of research indicates that exaggerated response to uncertainty of a future threat is at the core of anxiety and related disorders, underscoring the need for a better understanding of the underlying mechanisms. Although behavioral and neuroimaging studies have suggested a close relationship between uncertainty responses and cognitive control, little is known about what elements of uncertainty are more or less vulnerable to cognitive modulation in shaping aversive responses. Leveraging a novel paradigm, an n-back working memory task embedded within a modified threat-of-shock paradigm, we examined how the influences of different facets of uncertainty (i.e., occurrence and timing) on psychophysiological responses were modulated by cognitive load. Psychophysiological responses were assessed using the acoustic startle reflex. Replicating prior work, the effects of cognitive load and temporal unpredictability of threat on startle responses were evident. The effect of occurrence unpredictability appears to depend on other factors. Under low cognitive load, startle response was potentiated when both the occurrence and the timing of threat were predictable. Under high cognitive load, startle response was significantly reduced, especially when a threat context involves uncertainty in both temporal and probability domains. These observations provide a framework for refining the model of fear and anxiety and for understanding the etiology of psychological disorders characterized by maladaptive uncertainty responses.

Effects of Different Observational Angles in Learner-Chosen Video Self-Modeling on Task Acquisition and Retention

This study aimed to examine the influence of different observational angles in video self-modeling on task acquisition and retention. We randomly assigned 42 Japanese university students to three camera-angle groups, i.e., a front-angle, a rear-angle, and a control group. The participants performed a 3 × 6 × 3 cup-stacking task with three sequential laps. The front- and rear-angle groups viewed video self-modeling created from previously self-chosen videos. The retention phase was conducted 1 week after the acquisition phase. The rear-angle group demonstrated the fastest movement times in the acquisition phase. Our findings indicate that viewing learner-chosen video self-modeling from a rear angle enhances motor skill acquisition but does not contribute to motor skill learning.

The effects of object size on spatial orientation: an eye movement study

Introduction

The processing of visual information in the human brain is divided into two streams, namely, the dorsal and ventral streams, object identification is related to the ventral stream and motion processing is related to the dorsal stream. Object identification is interconnected with motion processing, object size was found to affect the information processing of motion characteristics in uniform linear motion. However, whether the object size affects the spatial orientation is still unknown.

Methods

Thirty-eight college students were recruited to participate in an experiment based on the spatial visualization dynamic test. Eyelink 1,000 Plus was used to collect eye movement data. The final direction difference (the difference between the final moving direction of the target and the final direction of the moving target pointing to the destination point), rotation angle (the rotation angle of the knob from the start of the target movement to the moment of key pressing) and eye movement indices under conditions of different object sizes and motion velocities were compared.

Results

The final direction difference and rotation angle under the condition of a 2.29°-diameter moving target and a 0.76°-diameter destination point were significantly smaller than those under the other conditions (a 0.76°-diameter moving target and a 0.76°-diameter destination point; a 0.76°-diameter moving target and a 2.29°-diameter destination point). The average pupil size under the condition of a 2.29°-diameter moving target and a 0.76°-diameter destination point was significantly larger than the average pupil size under other conditions (a 0.76°-diameter moving target and a 0.76°-diameter destination point; a 0.76°-diameter moving target and a 2.29°-diameter destination point).

Discussion

A relatively large moving target can resist the landmark attraction effect in spatial orientation, and the influence of object size on spatial orientation may originate from differences in cognitive resource consumption. The present study enriches the interaction theory of the processing of object characteristics and motion characteristics and provides new ideas for the application of eye movement technology in the examination of spatial orientation ability.

Corrigendum: Chunking in simultaneous interpreting: the impact of task complexity and translation directionality on lexical bundles

[This corrects the article DOI: 10.3389/fpsyg.2023.1252238.].

No Evidence That Working Memory Modulates the Plasticity of the Nociceptive System, as Measured by Secondary Mechanical Hypersensitivity

The effect of cognition on the plasticity of the nociceptive system remains controversial. In this study, we examined whether working memory can buffer against the development of secondary hypersensitivity. Thirty-five healthy women participated in 3 experimental conditions. In each condition, they underwent electrical stimulation of the skin for 2 minutes (middle-frequency electrical stimulation [MFS]), which induces secondary hypersensitivity. During MFS, participants executed either an individually tailored and rewarded n-back task (working memory condition), a rewarded reaction-time task (non-working memory condition), or no task at all (control condition). Before and after MFS, participants rated the self-reported intensity and unpleasantness of mechanical pinprick stimuli. Fear of MFS was also assessed. Heart rate variability was measured to examine potential differences between the 3 conditions and steady-state evoked potentials to the electrical stimulation were recorded to investigate differences in cortical responses. We report no significant difference in hypersensitivity between the 3 conditions. Moreover, engaging in the cognitive tasks did not affect the heart rate variability or the steady-state evoked potentials. Interestingly, higher fear of MFS predicted greater hypersensitivity. In conclusion, we found no evidence that working memory affects the plasticity of the nociceptive system, yet pain-related fear plays a role. PERSPECTIVE: This study shows that the execution of a cognitive task, irrespective of cognitive load or working memory, does not significantly modulate the development of secondary hypersensitivity, heart rate variability, or steady-state evoked potentials. However, higher pain-related fear seems to contribute to greater hypersensitivity.

Simulation-based bronchoscopy training: Randomized trial comparing worked example to video introduction

INTRODUCTION

Learning the complex skill of bronchoscopy involves the integration of cognitive domains and motor skills. The development of simulators has opened up new possibilities in bronchoscopy training. This study aimed at evaluating how effective the modeling example methodology is in training this skill and assessed its effect on cognitive load in learning.

METHODS

Forty-seven medical students participating in a simulator-based bronchoscopy training program were randomly allocated to a control group, receiving a video lesson, and the modeling example group. They were evaluated by the simulator's metrics at different time points: pre-, posttest, and 15 days and 12 months after training. Cognitive load was assessed with the modified Paas scale.

RESULTS

Simulation-based training was effective for both groups, based on simulator metrics (p < .05). The modeling example group outperformed the control group in all measures at posttest and after 15 days (p < .001). After 12 months, there was a decline in skill in both groups, but the modeling example group performed better (p < .001). Simulation-based training reduced cognitive load, more strongly so in the modeling example group (p < .001).

CONCLUSION

The modeling example group showed substantial benefits over the control group, both in reducing the cognitive load in learning and in retaining knowledge and skill after 15 days and 12 months.

Subjective Cognitive Load Evaluation of a Mobile Personal Health Record Application

Mobile Personal Health Records (mPHRs), which make it possible to track and manage users' health information, can be an important aid in improving people's health. Despite its potential benefits, poor usability of systems can hinder the adoption and use of mPHRs. This study aims to evaluate the usability of a mobile health application in terms of perceived cognitive workload and performance. The cognitive workload experienced by 30 volunteers (15 experienced and 15 inexperienced), was measured while performing the given tasks with the NASA-Task Load Index (NASA-RTLX) scale, and the duration of the fulfillment of the tasks by eye tracking device. While there was no significant difference between the two user groups in the completion time of the tasks, a significant difference was found in the perceived cognitive load. "Making an appointment", which could take much longer to complete than other tasks, resulted in the highest cognitive load for all users. Further usability research using think-aloud protocols and user interviews could provide insights into design improvements for reducing cognitive load and enhancing performance.

The Impact of Feedback Modalities and the Influence of Cognitive Load on Interpersonal Communication in Nonclinical Settings: Experimental Study Design

BACKGROUND

The escalating demands of modern health care systems, combined with the emotional toll of patient care, have led to an alarming increase in physician burnout rates. This burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, can hinder doctors' ability to connect with patients effectively. Moreover, the cognitive load arising from information overload and the need for multitasking can further hinder doctors' ability to connect with patients effectively. Understanding the complex relationship between physician burnout and cognitive load is crucial for devising targeted interventions that enhance physician well-being and promote effective physician-patient interactions. Implementing strategies to alleviate burnout and cognitive load can lead to improved health care experiences and patient outcomes.

OBJECTIVE

Our study explores the interplay between physician burnout and its potential impact on interpersonal communication, particularly focusing on the role of cognitive load using a pilot study in a nonclinical setting involving nonclinical participants.

METHODS

This study uses an experimental design to evaluate 3 feedback tools (haptic, visual, and postvisit summary) and measure the cognitive load they impose on nonclinical participants in a nonclinical environment. The NASA Task Load Index, a widely accepted measure of cognitive load, was used to quantify the cognitive load associated with the feedback tools. The study used a within-subject design, meaning participants experienced all 3 feedback methods. A sample of 18 nonclinical participants was selected using counterbalancing techniques.

RESULTS

Postsession feedback not only enhancing performance but also mitigating the influence of cognitive load as compared with real-time feedback (haptic+visual). Participants with interview experience showed lower cognitive load levels when exposed to real-time feedback as compared with novice users. In contrast, postsession feedback was more effective for novice users. In addition, cognitive workload emerged as a moderating factor in the relationship between feedback tools and their impact on performance, particularly in terms of speaking balance and pace. This moderating effect suggests that the correlation between feedback tool efficacy and performance varies based on an individual's cognitive load while using the feedback tool. The comparison of postfeedback with haptic feedback yielded a Z score of -3.245 and a P value of .001, while the comparison with visual feedback resulted in a Z score of -2.940 and a P value of .003. These outcomes underscore a significant disparity in the means between postsession feedback and real-time feedback (haptic+visual), with postsession feedback indicating the lowest mean score.

CONCLUSIONS

Through the examination of various feedback tools, this study yields significant and insightful comparisons regarding their usability and appropriateness in nonclinical settings. To enhance the applicability of these findings to clinical environments, further research encompassing diverse participant cohorts and clinical scenarios is warranted.

Lexical density, lexical diversity, and lexical sophistication in simultaneously interpreted texts: a cognitive perspective

Simultaneous interpreting (SI) is a cognitively demanding task that imposes a heavy cognitive load on interpreters. Interpreting into one's native (A language) or non-native language (B language), known as interpreting directionality, involves different cognitive demands. The cognitive requirements of simultaneous interpreting as well as interpreting directionality affect the interpreting process and product. This current study focused on the lexical features of a specially designed corpus of United Nations Security Council speeches. The corpus included non-interpreted speeches in US English (SubCorpusE), and texts interpreted from Chinese into English (A-into-B interpreted texts, SubCorpusC-E) and from Russian into English (B-into-A interpreted texts, SubCorpusR-E). Ten measures were used to analyze the lexical features of each subcorpus in terms of lexical density, lexical diversity, and lexical sophistication. The three subcorpora were regrouped into two pairs for the two research questions: SubCorpusR-E versus SubCorpusE and SubCorpusR-E versus SubCorpusC-E. The results showed that the interpreted texts in SubCorpusR-E exhibited simpler vocabulary features than the non-interpreted texts in SubCorpusE. In addition, compared with the A-into-B interpreted texts, the B-into-A interpreted texts demonstrated simplified lexical characteristics. The lexical features of the interpreted texts reflect that experienced simultaneous interpreters consciously adopt a simplified vocabulary approach to manage the cognitive load during simultaneous interpreting. This study provides new insights into the cognitive aspects of simultaneous interpreting, the impact of directionality, and the role of lexical strategies. These findings have practical implications for interpreter training, professional growth, and maintaining interpreting quality in diverse settings.

The Intensive Care Unit Bundle Board: A Novel Real-Time Data Visualization Tool to Improve Maintenance Care for Invasive Catheters

BACKGROUND

Critically ill patients are at greater risk of healthcare-associated infections (HAIs). The use of maintenance bundles helps to reduce this risk but also generates a rapid accumulation of complex data that is difficult to aggregate and subsequently act upon.

OBJECTIVES

We hypothesized that a digital display summarizing nursing documentation of invasive catheters (including central venous access devices, arterial catheters, and urinary catheters) would improve invasive device maintenance care and documentation. Our secondary objectives were to see if this summary would reduce the duration of problematic conditions, that is, characteristics associated with increased risk of infection.

METHODS

We developed and implemented a data visualization tool called the "Bundle Board" to display nursing observations on invasive devices. The intervention was studied in a 28-bed medical intensive care unit (MICU). The Bundle Board was piloted for 6 weeks in June 2022 and followed by a comparison phase, where one MICU had Bundle Board access and another MICU at the same center did not. We retrospectively applied tile color coding logic to prior nursing documentation from 2021 until the pilot phase to facilitate comparison pre- and post-Bundle Board release.

RESULTS

After adjusting for time, other quality improvement efforts, and nursing shift, multiple linear regression demonstrated a statistically significant improvement in the completion of catheter care and documentation during the pilot phase (p < 0.0001) and comparison phase (p = 0.002). The median duration of documented problematic conditions was significantly reduced during the pilot phase (p < 0.0001) and in the MICU with the Bundle Board (comparison phase, p = 0.027).

CONCLUSION

We successfully developed a data visualization tool that changed ICU provider behavior, resulting in increased completion and documentation of maintenance care and reduced duration of problematic conditions for invasive catheters in MICU patients.

Individualized Mental Fatigue Does Not Impact Neuromuscular Function and Exercise Performance

INTRODUCTION

Recent studies have questioned previous empirical evidence that mental fatigue negatively impacts physical performance. The purpose of this study was to investigate the critical role of individual differences in mental fatigue susceptibility by analyzing the neurophysiological and physical responses to an individualized mental fatigue task.

METHODS

In a preregistered ( https://osf.io/xc8nr/ ), randomized, within-participant design experiment, 22 recreational athletes completed a time to failure test at 80% of their peak power output under mental fatigue (individual mental effort) or control (low mental effort). Before and after the cognitive tasks, subjective feeling of mental fatigue, neuromuscular function of the knee extensors, and corticospinal excitability were measured. Sequential Bayesian analysis until it reached strong evidence in favor of the alternative hypothesis (BF 10 > 6) or the null hypothesis (BF 10 < 1/6) were conducted.

RESULTS

The individualized mental effort task resulted in a higher subjective feeling of mental fatigue in the mental fatigue condition (0.50 (95% confidence interval (CI), 0.39-0.62)) arbitrary units compared with control (0.19 (95% CI, 0.06-0.339)) arbitrary unit. However, exercise performance was similar in both conditions (control: 410 (95% CI, 357-463) s vs mental fatigue: 422 (95% CI, 367-477) s, BF 10 = 0.15). Likewise, mental fatigue did not impair knee extensor maximal force-generating capacity (BF 10 = 0.928) and did not change the extent of fatigability or its origin after the cycling exercise.

CONCLUSIONS

There is no evidence that mental fatigue adversely affects neuromuscular function or physical exercise; even if mental fatigue is individualized, computerized tasks seem not to affect physical performance.

Focus on evidence-based anatomy in contemporary anatomy education: Arguments in favor of a pragmatic approach

The concept of evidence-based anatomy (EBA) emerged in 2014 and has become a significant element in contemporary anatomy education. The evolving fabric of the medical education curriculum has necessitated critical changes in practice. EBA enables these changes to be incorporated seamlessly and implemented congruently into anatomy education programs. However, in parallel, non-evidence-based (classical) knowledge that has been built up through centuries of anatomical practice continues to be the core element of anatomy education in some countries/regions. Its inherent limitations hinder integration with clinical practice, leading to a rise in misadventures in the clinical setting. This viewpoint commentary highlights the strengths of EBA vis-à-vis the related attributes of classical anatomy. Appropriate arguments show that EBA helps to reduce cognitive load and enables knowledge to be delivered through innovative education tools. EBA also helps to create an inclusive learning environment in a technology-driven era. Moreover, empowered by robust resources, it is driving the pertinent amalgamation of anatomy knowledge with clinical practice. This viewpoint article endorses the adoption of EBA in contemporary anatomy education on the basis of its potential for shaping future anatomical practice.

The impact of speech type on listening effort and intelligibility for native and non-native listeners

Listeners are routinely exposed to many different types of speech, including artificially-enhanced and synthetic speech, styles which deviate to a greater or lesser extent from naturally-spoken exemplars. While the impact of differing speech types on intelligibility is well-studied, it is less clear how such types affect cognitive processing demands, and in particular whether those speech forms with the greatest intelligibility in noise have a commensurately lower listening effort. The current study measured intelligibility, self-reported listening effort, and a pupillometry-based measure of cognitive load for four distinct types of speech: (i) plain i.e. natural unmodified speech; (ii) Lombard speech, a naturally-enhanced form which occurs when speaking in the presence of noise; (iii) artificially-enhanced speech which involves spectral shaping and dynamic range compression; and (iv) speech synthesized from text. In the first experiment a cohort of 26 native listeners responded to the four speech types in three levels of speech-shaped noise. In a second experiment, 31 non-native listeners underwent the same procedure at more favorable signal-to-noise ratios, chosen since second language listening in noise has a more detrimental effect on intelligibility than listening in a first language. For both native and non-native listeners, artificially-enhanced speech was the most intelligible and led to the lowest subjective effort ratings, while the reverse was true for synthetic speech. However, pupil data suggested that Lombard speech elicited the lowest processing demands overall. These outcomes indicate that the relationship between intelligibility and cognitive processing demands is not a simple inverse, but is mediated by speech type. The findings of the current study motivate the search for speech modification algorithms that are optimized for both intelligibility and listening effort.

Impact of delirium intervention on cognitive load among nurses in the intensive care unit: A multi-centre cluster randomized controlled trial

BACKGROUND

High cognitive load in nurses is a common problem in the intensive care unit (ICU). However, it remains unclear what different types of cognitive load the ICU nurses have experienced during the implementation of delirium interventions.

AIM

To describe the characteristics and explore the effect of implementing a delirium intervention on the cognitive load of nurses working in the ICU.

METHODS

A cluster-randomized controlled clinical trial was conducted. Six ICUs were randomized in a 1:1 ratio, and eligible nurses from these units provided either a delirium bundle intervention in addition to usual care (27 nurses) or usual care alone. An instrument was used to measure different types of cognitive load (MDT-CL), assessing intrinsic, extraneous and germane cognitive load. The repeated measures analysis of variance was used to detect between-group differences.

RESULTS

Among these nurses, significant between-group differences were identified in terms of their overall (P < 0.001), intrinsic (P < 0.001) and extraneous (P < 0.001) cognitive load. There was no significant change observed in the germane cognitive load (P = 0.489) in the delirium intervention group.

CONCLUSION

It is important to understand how the implementation of a delirium intervention affects different types of cognitive load in nurses, in order that tailored strategies can be applied to reduce cognitive load in ICU nurses.

Listening to Misinformation while Driving: Cognitive Load and the Effectiveness of (Repeated) Corrections

Corrected misinformation can continue to influence inferential reasoning. It has been suggested that such continued influence is partially driven by misinformation familiarity, and that corrections should therefore avoid repeating misinformation to avoid inadvertent strengthening of misconceptions. However, evidence for such familiarity-backfire effects is scarce. We tested whether familiarity backfire may occur if corrections are processed under cognitive load. Although misinformation repetition may boost familiarity, load may impede integration of the correction, reducing its effectiveness and therefore allowing a backfire effect to emerge. Participants listened to corrections that repeated misinformation while in a driving simulator. Misinformation familiarity was manipulated through the number of corrections. Load was manipulated through a math task administered selectively during correction encoding. Multiple corrections were more effective than a single correction; cognitive load reduced correction effectiveness, with a single correction entirely ineffective under load. This provides further evidence against familiarity-backfire effects and has implications for real-world debunking.

Chunking in simultaneous interpreting: the impact of task complexity and translation directionality on lexical bundles

This study explored the use of phraseological frames (p-frames), a type of lexical bundle, by simultaneous interpreters as a strategy for managing cognitive loads. Specifically, using a comparable corpus of United Nations Security Council conferences, the study employed kfNgram to automatically identify the p-frames, and investigated their variations, regarding frequency, fixedness, structures, and functions among L1, L1-L2, and L2-L1 texts, which differ in cognitive loads due to task complexity and directionality of interpreting. The findings indicated that interpreters used more p-frames as cognitive loads increased; No significant difference was identified in fixedness as all texts tended to employ heavily formulaic and relatively fixed p-frames. Directionality correlated with grammatical preferences, with retour interpreting relying more on content-word-based p-frames. Additionally, task complexity correlated with functional preferences, with self-expression characterized by more stance expressions in the simple task. This study innovatively addressed the interaction of two factors that generate cognitive loads in interpreting and filled a research gap by providing empirical evidence on how directionality affects the use of formulaic language.

Seeing eye to eye: trustworthy embodiment for task-based conversational agents

Smart speakers and conversational agents have been accepted into our homes for a number of tasks such as playing music, interfacing with the internet of things, and more recently, general chit-chat. However, they have been less readily accepted in our workplaces. This may be due to data privacy and security concerns that exist with commercially available smart speakers. However, one of the reasons for this may be that a smart speaker is simply too abstract and does not portray the social cues associated with a trustworthy work colleague. Here, we present an in-depth mixed method study, in which we investigate this question of embodiment in a serious task-based work scenario of a first responder team. We explore the concepts of trust, engagement, cognitive load, and human performance using a humanoid head style robot, a commercially available smart speaker, and a specially developed dialogue manager. Studying the effect of embodiment on trust, being a highly subjective and multi-faceted phenomena, is clearly challenging, and our results indicate that potentially, the robot, with its anthropomorphic facial features, expressions, and eye gaze, was trusted more than the smart speaker. In addition, we found that embodying a conversational agent helped increase task engagement and performance compared to the smart speaker. This study indicates that embodiment could potentially be useful for transitioning conversational agents into the workplace, and further in situ, "in the wild" experiments with domain workers could be conducted to confirm this.

Use of a Novel Theory-Based Pragmatic Tool to Evaluate the Quality of Instructor-Led Exercise Videos to Promote Youth Physical Activity at Home: Preliminary Findings

BACKGROUND

Exercise videos that work to minimize cognitive load (the amount of information that working memory can hold at one time) are hypothesized to be more engaging, leading to increased PA participation.

PURPOSE

To use a theory-based pragmatic tool to evaluate the cognitive load of instructor-led exercise videos associated with the Interrupting Prolonged Sitting with ACTivity (InPACT) program.

METHODS

Exercise videos were created by physical education teachers and fitness professionals. An evaluation rubric was created to identify elements each video must contain to reduce cognitive load, which included three domains with four components each [technical (visual quality, audio quality, matching modality, signaling), content (instructional objective, met objective, call-to-action, bias), and instructional (learner engagement, content organization, segmenting, weeding)]. Each category was scored on a 3-point scale from 0 (absent) to 2 (proficient). A video scoring 20-24 points induced low cognitive load, 13-19 points induced moderate cognitive load, and less than 13 points induced high cognitive load. Three reviewers independently evaluated the videos and then agreed on scores and feedback.

RESULTS

All 132 videos were evaluated. Mean video total score was 20.1 ± 0.7 points out of 24. Eighty-five percent of videos were rated low cognitive load, 15% were rated moderate cognitive load, and 0% were rated high cognitive load. The following components scored the highest: audio quality and matching modality. The following components scored the lowest: signaling and call-to-action.

CONCLUSIONS

Understanding the use of a pragmatic tool is a first step in the evaluation of InPACT at Home exercise videos. Our preliminary findings suggest that the InPACT at Home videos had low cognitive load. If future research confirms our findings, using a more rigorous study design, then developing a collection of instructor-led exercise videos that induce low cognitive load may help to enhance youth physical activity participation in the home environment.

Prediction of mental effort derived from an automated vocal biomarker using machine learning in a large-scale remote sample

Introduction

Biomarkers of mental effort may help to identify subtle cognitive impairments in the absence of task performance deficits. Here, we aim to detect mental effort on a verbal task, using automated voice analysis and machine learning.

Methods

Audio data from the digit span backwards task were recorded and scored with automated speech recognition using the online platform NeuroVocalixTM, yielding usable data from 2,764 healthy adults (1,022 male, 1,742 female; mean age 31.4 years). Acoustic features were aggregated across each trial and normalized within each subject. Cognitive load was dichotomized for each trial by categorizing trials at >0.6 of each participants' maximum span as "high load." Data were divided into training (60%), test (20%), and validate (20%) datasets, each containing different participants. Training and test data were used in model building and hyper-parameter tuning. Five classification models (Logistic Regression, Naive Bayes, Support Vector Machine, Random Forest, and Gradient Boosting) were trained to predict cognitive load ("high" vs. "low") based on acoustic features. Analyses were limited to correct responses. The model was evaluated using the validation dataset, across all span lengths and within the subset of trials with a four-digit span. Classifier discriminant power was examined with Receiver Operating Curve (ROC) analysis.

Results

Participants reached a mean span of 6.34 out of 8 items (SD = 1.38). The Gradient Boosting classifier provided the best performing model on test data (AUC = 0.98) and showed excellent discriminant power for cognitive load on the validation dataset, across all span lengths (AUC = 0.99), and for four-digit only utterances (AUC = 0.95).

Discussion

A sensitive biomarker of mental effort can be derived from vocal acoustic features in remotely administered verbal cognitive tests. The use-case of this biomarker for improving sensitivity of cognitive tests to subtle pathology now needs to be examined.

Machine learning-based cognitive load prediction model for AR-HUD to improve OSH of professional drivers

Motivation

Augmented reality head-up display (AR-HUD) interface design takes on critical significance in enhancing driving safety and user experience among professional drivers. However, optimizing the above-mentioned interfaces poses challenges, innovative methods are urgently required to enhance performance and reduce cognitive load.

Description

A novel method was proposed, combining the IVPM method with a GA to optimize AR-HUD interfaces. Leveraging machine learning, the IVPM-GA method was adopted to predict cognitive load and iteratively optimize the interface design.

Results

Experimental results confirmed the superiority of IVPM-GA over the conventional BP-GA method. Optimized AR-HUD interfaces using IVPM-GA significantly enhanced the driving performance, and user experience was enhanced since 80% of participants rated the IVPM-GA interface as visually comfortable and less distracting.

Conclusion

In this study, an innovative method was presented to optimize AR-HUD interfaces by integrating IVPM with a GA. IVPM-GA effectively reduced cognitive load, enhanced driving performance, and improved user experience for professional drivers. The above-described findings stress the significance of using machine learning and optimization techniques in AR-HUD interface design, with the aim of enhancing driver safety and occupational health. The study confirmed the practical implications of machine learning optimization algorithms for designing AR-HUD interfaces with reduced cognitive load and improved occupational safety and health (OSH) for professional drivers.

Touch may reduce cognitive load during assisted typing by individuals with developmental disabilities

Many techniques have attempted to provide physical support to ease the execution of a typing task by individuals with developmental disabilities (DD). These techniques have been controversial due to concerns that the support provider's touch can influence the typed content. The most common interpretation of assisted typing as an ideomotor phenomenon has been qualified recently by studies showing that users with DD make identifiable contributions to the process. This paper suggests a neurophysiological pathway by which touch could lower the cognitive load of seated typing by people with DD. The required sensorimotor processes (stabilizing posture and planning and executing manual reaching movements) and cognitive operations (generating and transcribing linguistic material) place concurrent demands on cognitive resources, particularly executive function (EF). A range of developmental disabilities are characterized by deficits in sensorimotor and EF capacity. As light touch has been shown to facilitate postural coordination, it is proposed that a facilitator's touch could assist the seated typist with sensorimotor and EF deficits by reducing their sensorimotor workload and thereby freeing up shared cognitive resources for the linguistic elements of the task. This is the first theoretical framework for understanding how a facilitator's touch may assist individuals with DD to contribute linguistic content during touch-assisted typing.

Expertise reversal effect in a pen-tablet-based learning environment: The role of learningcentered emotions in the interplay between learner expertise and task complexity

The study investigated interactions between learner expertise and task complexity evaluated from both cognitive and affective perspectives. One hundred and seventy-three students, both novices and advanced learners, were asked to learn Japanese writing in a pen-tablet-based digital learning environment with varying task complexity levels. Cognitive load and learning-centred emotions were measured at intervals during learning, while writing performance was monitored by runtime tracking. Results indicated that while advanced learners performed better than novices across the range of task complexity, the moderate task complexity was shown to be superior in enhancing performance for both levels of expertise. Results for learning-centred emotions showed that advanced learners reported lower enjoyment and higher frustration when completing the low complexity task, whereas the moderately complex task was reported to be the most enjoyable and less frustrating for these learners. No significant difference in emotions was found across levels of task complexity for novices. Finally, a constructed composite indicator of cognitive-affective efficiency of instructional conditions showed a significant interaction between levels of learner expertise and task complexity primarily caused by affective factors.

Pupillometric and blink measures of diverse task loads: Implications for working memory models

BACKGROUND

Inconsistent observations of pupillary response and blink change in response to different specific tasks raise questions regarding the relationship between eye measures, task types and working memory (WM) models. On the one hand, studies have provided mixed evidence from eye measures about tasks: pupil size has mostly been reported to increase with increasing task demand while this expected change was not observed in some studies, and blink rate has exhibited different trends in different tasks. On the other hand, a WM model has been developed to integrate a component to reconcile recent findings that the human motor system plays an important role in cognition and learning. However, how different tasks correlate with WM components has not been experimentally examined using eye activity measurements.

AIMS

The current study uses a four-dimensional task load framework to bridge eye measures, task types and WM models.

SAMPLE

Twenty participants (10 males, 10 females; Age: M = 25.8, SD = 7.17) above 18 years old volunteered. All participants had normal or corrected to normal vision with contact lenses and had no eye diseases causing obvious excessive blinking.

METHODS

We examined the ability of pupil size and blink rate to index low and high levels of cognitive, perceptual, physical and communicative task load. A network of the four load types and WM components was built and analysed to verify the necessity of integrating a physical task-related component into the WM model.

RESULTS

Results demonstrate that pupil size can index cognitive load and communicative load but not perceptual or physical load. Blink rate can index the level of cognitive load but is best at discriminating perceptual tasks from other types of tasks. Furthermore, pupil size measurement of the four task types was explained better during structural and factor analysis by a WM model that integrates a movement-related component.

CONCLUSIONS

This research provides new insights into the relationship between eye measures, task type and WM models and provides a comprehensive understanding from which to predict pupil size and blink behaviours in more complex and practical tasks.

Relationship Between Residents' Physiological Stress and Faculty Leadership Skills in a Department of Surgery

BACKGROUND

Leadership skills of team leaders can impact the functioning of their teams. It is unknown whether attending surgeons' leadership skills impact residents' physiological stress. This study sought to (1) assess the relationship between attending surgeons' leadership skills and residents' physiological stress and (2) to characterize lifestyle behaviors associated with resident physiological stress. We hypothesized that strong attending leadership skills would be associated with low resident physiological stress.

STUDY DESIGN

This prospective observational cohort study was conducted at a single urban, academic medical center in the US, over 12 months. Residents were enrolled during their rotation of 1 to 2 months on the Trauma and ICU services. The primary predictor was the attending surgeons' leadership skills that were measured using a weekly survey filled out by residents, using the Surgeons' Leadership Inventory (SLI). The SLI uses a 4-point Likert scale to measure surgeons' leadership skills across eight domains. The primary outcome was residents' physiological stress, which was measured by their Heart Rate Variability (HRV). We recorded the residents' HRV with a WHOOP strap that was continuously worn on the wrist or the bicep. We used multivariate repeated measures gamma regression to assess the relationship between attending leadership skills and residents' physiological stress, adjusting for hours of sleep, age, and service.

RESULTS

Sixteen residents were enrolled over 12 months. The median attending surgeons' leadership score was 3.8 (IQR: 3.2-4.0). The median residents' percent of maximal HRV was 70.8% (IQR: 56.7-83.7). Repeated measure gamma regression model demonstrated a minimal nonsignificant increase of 1.6 % (95% CI: -5.6, 8.9; p-value = 0.65) in the percent of maximal HRV (less resident physiological stress) for every unit increase in leadership score. There was an increase of 2.9% (95% CI= 1.6, 4.2; p-value < 0.001) in the percent of maximal HRV per hour increase in sleep and a significant decrease of 10.9% (95% CI= -16.8, -5.2; < 0.001) in the percent of HRV when working in the ICU compared to the Trauma service.

CONCLUSION

This study revealed that more residents' sleep was associated with lower physiological stress. Attending surgeons' leadership skills were not associated with residents' physiological stress.

Examining Factors Influencing Cognitive Load of Computer Programmers

In this study, the factors influencing the cognitive load of computer programmers during the perception of different code tasks were investigated. The eye movement features of computer programmers were used to provide a significant relationship between the perceptual processes of the sample codes and cognitive load. Thanks to the relationship, the influence of various personal characteristics of programmers on cognitive load was examined. Various personal parameters such as programming experience, age, native language, and programming frequency were used in the study. The study was performed on the Eye Movements in Programming (EMIP) dataset containing 216 programmers with different characteristics. Eye movement information recorded during two different code comprehension tasks was decomposed into sub-information, such as pupil movement speed and diameter change. Rapid changes in eye movement signals were adaptively detected using the z-score peak detection algorithm. Regarding the cognitive load calculations, canonical correlation analysis was used to build a statistically significant and efficient mathematical model connecting the extracted eye movement features and the different parameters of the programmers, and the results were statistically significant. As a result of the analysis, the factors affecting the cognitive load of computer programmers for the related database were converted into percentages, and it was seen that linguistic distance is an essential factor in the cognitive load of programmers and the effect of gender on cognitive load is quite limited.

Identification of Language-Induced Mental Load from Eye Behaviors in Virtual Reality

Experiences of virtual reality (VR) can easily break if the method of evaluating subjective user states is intrusive. Behavioral measures are increasingly used to avoid this problem. One such measure is eye tracking, which recently became more standard in VR and is often used for content-dependent analyses. This research is an endeavor to utilize content-independent eye metrics, such as pupil size and blinks, for identifying mental load in VR users. We generated mental load independently from visuals through auditory stimuli. We also defined and measured a new eye metric, focus offset, which seeks to measure the phenomenon of "staring into the distance" without focusing on a specific surface. In the experiment, VR-experienced participants listened to two native and two foreign language stimuli inside a virtual phone booth. The results show that with increasing mental load, relative pupil size on average increased 0.512 SDs (0.118 mm), with 57% reduced variance. To a lesser extent, mental load led to fewer fixations, less voluntary gazing at distracting content, and a larger focus offset as if looking through surfaces (about 0.343 SDs, 5.10 cm). These results are in agreement with previous studies. Overall, we encourage further research on content-independent eye metrics, and we hope that hardware and algorithms will be developed in the future to further increase tracking stability.

Food Choices after Cognitive Load: An Affective Computing Approach

Psychology and nutritional science research has highlighted the impact of negative emotions and cognitive load on calorie consumption behaviour using subjective questionnaires. Isolated studies in other domains objectively assess cognitive load without considering its effects on eating behaviour. This study aims to explore the potential for developing an integrated eating behaviour assistant system that incorporates cognitive load factors. Two experimental sessions were conducted using custom-developed experimentation software to induce different stimuli. During these sessions, we collected 30 h of physiological, food consumption, and affective states questionnaires data to automatically detect cognitive load and analyse its effect on food choice. Utilising grid search optimisation and leave-one-subject-out cross-validation, a support vector machine model achieved a mean classification accuracy of 85.12% for the two cognitive load tasks using eight relevant features. Statistical analysis was performed on calorie consumption and questionnaire data. Furthermore, 75% of the subjects with higher negative affect significantly increased consumption of specific foods after high-cognitive-load tasks. These findings offer insights into the intricate relationship between cognitive load, affective states, and food choice, paving the way for an eating behaviour assistant system to manage food choices during cognitive load. Future research should enhance system capabilities and explore real-world applications.

The Effect of Implementation Intentions on Prospective Memory Commission Errors under Different Cognitive Loads

Prospective memory (PM) refers to the ability to remember to perform a planned event or activity at a specific time or situation in the future. Implementation intentions can promote a connection between PM cues and intended actions, thus improving an individual's PM performance. However, this simple and effective encoding strategy may also have negative effects. For example, an implementation intention may result in PM commission errors that occur when an individual makes a false PM response to repeated PM cues that are no longer relevant as the PM task has been completed. Existing studies have explored the effect of implementation intentions on PM commission errors under low cognitive load. However, the role of implementation intentions in promoting linkages between PM cues and actions tends to disintegrate under high cognitive loads. Therefore, this study aimed to explore the effect of implementation intentions on PM commission errors under different cognitive load conditions. In this study, 58 college students participated in a mixed experimental design of 2 (encoding methods: implementation intention, standard) × 2 (cognitive load conditions: low, high). The results showed that implementation intentions promoted PM commission errors under the low-cognitive-load condition only, and there was no difference in the performance of ongoing tasks between the implementation intention encoding and the standard encoding conditions. However, individuals in the implementation intention condition reacted more slowly when encountering previous PM cues. The results suggest that the effect of implementation intentions on PM commission errors relies upon automated processing as a whole. However, individuals in the implementation intention condition required more attentional resources to suppress the no-longer-relevant intended actions when previous PM cues appeared, supporting the dual-mechanism theory.

Cognition Uniquely Influences Dual-Task Tandem Gait Performance Among Athletes With a Concussion History

BACKGROUND

After a concussion, there are unique associations between static balance and landing with cognition. Previous research has explored these unique correlations, but the factor of time, dual-task, and different motor tasks leave gaps within the literature. The purpose of this study was to determine the associations between cognition and tandem gait performance.

HYPOTHESIS

We hypothesized that athletes with a concussion history would display stronger associations compared with athletes without a concussion history between cognition and tandem gait.

STUDY DESIGN

Cross-sectional.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 126 athletes without (56.3% female; age, 18.8 ± 1.3 years; height, 176.7 ± 12.3 cm; mass, 74.8 ± 19.0 kg) and 42 athletes with (40.5% female; age, 18.8 ± 1.3 years; height, 179.3 ± 11.9 cm; mass, 81.0 ± 25.1 kg) concussion history participated. Cognitive performance was assessed with CNS Vital Signs. Tandem gait was performed on a 3-meter walkway. Dual-task tandem gait included a concurrent cognitive task of serial subtraction, reciting months backward, or spelling words backward.

RESULTS

Athletes with a concussion history exhibited a larger number of significant correlations compared with athletes without a concussion history for cognition and dual-task gait time (4 significant correlations: rho-range, -0.377 to 0.358 vs 2 significant correlations: rho, -0.233 to 0.179) and dual-task cost gait time (4 correlations: rho range, -0.344 to 0.392 vs 1 correlation: rho, -0.315). The time between concussion and testing did significantly moderate any associations (P = 0.11-0.63). Athletes with a concussion history displayed better dual-task cost response rate (P = 0.01). There were no other group differences for any cognitive (P = 0.13-0.97) or tandem gait (P = 0.20-0.92) outcomes.

CONCLUSION

Athletes with a concussion history display unique correlations between tandem gait and cognition. These correlations are unaffected by the time since concussion.

CLINICAL RELEVANCE

These unique correlations may represent shared neural resources between cognition and movement that are only present for athletes with a concussion history. Time does not influence these outcomes, indicating the moderating effect of concussion on the correlations persists long-term after the initial injury.

Analyzing and supporting mental representations and strategies in solving Bayesian problems

Solving Bayesian problems poses many challenges, such as identifying relevant numerical information, classifying, and translating it into mathematical formula language, and forming a mental representation. This triggers research on how to support the solving of Bayesian problems. The facilitating effect of using numerical data in frequency format instead of probabilities is well documented, as is the facilitating effect of given visualizations of statistical data. The present study not only compares the visualizations of the 2 × 2 table and the unit square, but also focuses on the results obtained from the self-creation of these visualizations by the participants. Since it has not yet been investigated whether the better correspondence between external and internal visualization also has an effect on cognitive load when solving Bayesian tasks, passive and active cognitive load are additionally measured. Due to the analog character and the proportional representation of the numerical information by the unit square, it is assumed that the passive cognitive load is lower when using the unit square as visualization than when using the 2 × 2 table. The opposite is true for active cognitive load.

Cognitive Load Moderates the Effects of Total Sleep Deprivation on Working Memory: Evidence from Event-Related Potentials

Purpose: The function of working memory (WM) is impaired by total sleep deprivation (TSD) and cognitive load. However, it is unclear whether the load modulates the effect of TSD on WM. We conducted a pilot study to investigate the effects of 36 h of TSD on WM under different load levels. Materials and methods: Twenty-two male students aged 18-25 years were enrolled, who underwent two types of sleep conditions (baseline and 36 h TSD), where they performed two N-back WM tasks (one-back task and two-back task) with simultaneous electroencephalography recordings. Results: Repeated measures analysis of variance (ANOVA) indicated that, with the increasing load, the reaction time increased and the accuracy decreased. After TSD, the correct number per unit time decreased. The significant interaction effect of the P3 amplitudes between the load level and the sleep condition showed that the reduction in the amplitude of P3 in the two-back task due to TSD was more obvious than that in the one-back task. Conclusions: Our results provided evidence for the moderation of load on the impairment of TSD on WM. The degree of TSD-induced impairment for a higher load was greater than that for a lower load. The current study provides new insights into the mechanisms by which sleep deprivation affects cognitive function.